Bahdila D, Alhazmi H, Alfarsi A S, Alzahrani L Y, Koumu A I, Alshaikh R H, Khalifa S O, Natto Z S
Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Preventive Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia.
JDR Clin Trans Res. 2025 Jul 2:23800844251347914. doi: 10.1177/23800844251347914.
The cascade of care (COC) approach assesses key stages in care, including screening, diagnosis, treatment, and control. It has been applied to communicable and noncommunicable diseases but is yet to be used in oral health.
To adapt the COC framework for pediatric oral health and apply it in a cross-sectional study of schoolchildren in Jeddah, Saudi Arabia, to assess dental needs, diagnosis, treatment, and follow-up.
A 2-stage process was used to first adapt the 4-step COC model for pediatric dental needs and to produce a survey questionnaire. Stratified random sampling was then used to recruit children in grades 4 to 6 in primary schools in Jeddah, Saudi Arabia, from October 2023 to January 2024. Parents completed COC questions, and children completed dental examinations. Descriptive statistics and multilevel logistic regression models were used to assess outcomes, including unmet dental needs in context.
A total of 783 schoolchildren from 11 primary schools were included in the cross-sectional study. The largest loss of care occurred at the treatment stage, where 41.3% of those who had visited a dentist and were diagnosed had completed their treatment. Children who had not visited a dentist in >12 mo were less likely to be diagnosed, complete treatment, or receive follow-up care when compared with those who had seen a dentist within 12 mo ( < 0.05).
This study is the first to adapt and apply the COC framework in pediatric oral health. The total unmet dental need was high, particularly for children visiting the dentist for symptomatic reasons (i.e., pain or extraction). This model lays the groundwork for more targeted assessments at national or subnational levels.Knowledge Transfer Statement:This is the first time that the cascade of care (COC) approach has been adapted and applied in a pediatric oral health case study in Jeddah, Saudi Arabia, to understand gaps in children's dental care. It showed how the COC can highlight where systems might be underperforming and where additional data are needed. Introducing the COC framework in pediatric oral health could improve data collection across key stages of care, such as access, diagnosis, treatment, and follow-up.
连续护理（COC）方法评估护理的关键阶段，包括筛查、诊断、治疗和控制。它已应用于传染病和非传染病，但尚未用于口腔健康领域。
调整COC框架以适用于儿童口腔健康，并将其应用于沙特阿拉伯吉达市学童的横断面研究，以评估牙齿需求、诊断、治疗和随访情况。
采用两阶段流程，首先调整4步COC模型以满足儿童牙齿需求，并编制调查问卷。然后采用分层随机抽样方法，于2023年10月至2024年1月在沙特阿拉伯吉达市的小学四至六年级招募儿童。家长完成COC相关问题，儿童接受牙齿检查。使用描述性统计和多水平逻辑回归模型评估结果，包括在实际情况下未满足的牙齿需求。
共有来自11所小学的783名学童纳入横断面研究。护理缺失最多的发生在治疗阶段，在看过牙医并被诊断的儿童中，41.3%完成了治疗。与在12个月内看过牙医的儿童相比，超过12个月未看过牙医的儿童被诊断、完成治疗或接受后续护理的可能性较小（P<0.05）。
本研究首次调整并应用COC框架于儿童口腔健康领域。未满足的牙齿需求总体较高，尤其是因出现症状（如疼痛或拔牙）而看牙医的儿童。该模型为国家或次国家层面更具针对性的评估奠定了基础。
这是连续护理（COC）方法首次在沙特阿拉伯吉达市的儿童口腔健康案例研究中进行调整和应用，以了解儿童牙齿护理方面的差距。它展示了COC如何突出系统可能表现不佳的地方以及需要额外数据的地方。在儿童口腔健康中引入COC框架可以改善护理关键阶段的数据收集，如就诊、诊断、治疗和随访。
